Gender Assessment Highlights

A Gender Assessment is a confidential discussion about one's thoughts and feelings about the gender assigned at birth and how comfortable one feels about their body - (especially after puberty). This is a wonderful opportunity to sit with a gender affirming provider who understands the unique challenges one faces as they consider transitioning into their affirmed gender. Here are some highlights of an actual gender assessment:

New Name and Pronouns:

Do you have a name you prefer other than assigned name?

What are your affirmed pronouns?

What gender affirming services are you considering?

• Masculinizing or Feminizing Hormones?
• Permanent Face or Body Hair Removal?
• Breast Enhancement or Masculinizing Top Surgery?
• Facial Affirming Surgery, including Tracheal Shave?
• Voice Therapy or Voice Surgery?
• Complex Gender Affirming Surgery such as: Hysterectomy, Orchiectomy with or without Oophorectomy? Vaginoplasty, Metoidioplasty, or Phalloplasty?

When did you first discover your affirmed or true gender?

How often do you dress in your affirmed gender (less applicable for nonbinary people).

Who in your life is supportive of your gender transition?

Dysphoria? Do you experience dysphoria with any aspect of your physical being?

• Primary Sex Characteristics: Genitals present at birth such as Penis or Vagina?
• Secondary Sex Characteristics: Changes that occurred with puberty? 

History of Gender Affirming Hormones? Gender Affirming Procedures or Surgeries?

Informed Consent

• Mental or Physical expectations from hormones or surgery?
• Your understanding of the the surgical procedure (if requesting surgery)?
• How might pursuing hormones or other gender affirming services potentially impact your living situation, employment, family or intimate relationships or other important areas of your life?
• Plan to discuss full risks and benefits with Endocrinologist (hormones) or Surgeon (surgery).

Complete Psychological Screening

• Depression and Anxiety, ADD / ADHD, PTSD, Eating Disorders.
• Alcohol, Drug, Tobacco use / abuse.
• History of Self Injury, Suicide Thoughts, Suicide Attempts, Hospitalizations.

Dysphoria Symptoms (from DSM 5 text revision)

• Difference between gender assigned at birth / affirmed gender?
• Experienced / Desired Primary or Secondary Sex Characteristics? (Primary Sex Characteristics refers to your genitals and Secondary Sex Characteristics refers to the physical changes brought about as a result of puberty.)
• Desire to be rid of primary or secondary characteristics?
• Desire to be a gender other than the one assigned at birth?
• If you had to live in the gender assigned at birth for the rest of your life, how would this impact your quality of life or happiness? If your only option was to live in (been seen as) the gender assigned at birth, how would this impact your happiness or quality of life?

Relief:

• For many people, their gender assessment is their first opportunity to sit with someone who affirms who they are.
• This is an opportunity to express the pain of being assigned a gender that has caused them significant distress to make positive plans to transform their physical body to match their internal truth.
• Sometimes there are significant mental or physical health challenges that need to be addressed before moving forward with permanent and irreversible gender affirming hormones or surgery.
• And, a Gender Assessment is a very important step in living as their true self.